Here’s a takeaway from season one of Steven Soderbergh’s dangerous and brilliant Victorian medical drama The Knick: The march to modern medicine involves many detours both treacherous and deadly, and the prescribed cure is often worse than the disease it’s meant to treat. Case in point, the season one finale’s closing shot—a bottle of Bayer’s new wonder drug intended to alleviate the pain of Dr. Thackery’s cocaine withdrawal. It’s called heroin, which leaves us with no question that a few months under its spell will not be kind to the good doctor. Here’s another takeaway: Medicine may have become more humane over time; people have not.

We begin with Nurse Lucy Elkins who has been writing to Thack during his time at the sanitarium. Although her letters have gone unanswered, she continues to fill him in on what he (and we) have been missing. Sister Harriet is awaiting trial, presumably for performing abortions. Dr. Gallinger is no longer suspended but has not returned to work, and The Knick will soon be moving uptown where it will serve a wealthier clientele. Without Thack, Nurse Elkins complains, her days are long, which is to say that with him gone, The Knick is just a hospital, the doctors just doctors, and her world is empty without the her lover’s addictive madness and maniacal genius. Let’s hope he gets “well” soon.

So how bad are things with Thack? We’ll shortly find out when we witness him peeling back the cartilage on a young woman’s nose, inserting a wire bridge, then replacing the skin. (This is The Knick, remember, where Soderbergh’s gorgeous cinematography unapologetically revels in and reveals significant corporeal horrors.) There’s a split second of hope that Thack is back in business. But when the camera gives us a reprieve from his patient’s exposed nose bone, it is to reveal Thack’s sallow junkie’s face, punctuated with a fever blister. Procedure complete, he demands his preferred payment of the sanitarium’s warden—phials of heroin. The road to recovery this is not.

Let’s step away, with a promise to check up on the doc, and visit two other people scattered in the wreckage of last season. (Much of this episode is devoted to both surveying this wreckage and drawing back those whom it dispelled.) Cornelia has brought her devoted (and affluent) altruism to San Francisco where she is trying to get supplies to a neighborhood of Chinese immigrants that has been quarantined. She pawns the earrings that were a wedding gift from her lecherous father-in-law to bribe the police in order to gain access to the neighborhood. But if she thinks she has shed sleazy Mr. Showalter with this exchange, she’s in for a surprise when she returns home to find the man himself waiting for her. He has good news: He’s offered to move her and Philip back to New York and install them in an 11-bedroom apartment (which I cannot wait to see) at the base of Central Park.

Cornelia, who’s been languishing out west, is eager to get back to her family and to The Knick. But on returning to New York, it looks as if she’s played right into her father-in-law’s hand—the apartment he promised is not ready, and she and Philip are going to be compelled to live under his roof for five months.

Also in an unpleasant living situation is Sister Harriet who awaits trial in a dismal women’s penitentiary. She is visited by her Mother Superior, who spouts the same sort of religious vitriol about abortion you would hear at a Westboro Baptist Church rally or the next GOP debate. The Mother Superior accuses Sister Harriet of being a “devil on earth” and a “murderer of innocents.” Sister Harriet remains calmly laconic throughout. Her only defense: “The women just needed help, and I helped them.” This charitable explanation does nothing to appease the Mother Superior who tells Harriet that she should have left her to die when she was a little girl. Nice.

Fortunately Sister Harriet’s next visitor, Tom Cleary, vows to clear her name by hiring a fancy pants uptown lawyer like the rich folk have. And you shouldn’t bet against him. Sister Harriet manages to unearth the humanity buried deep in his tough Irish heart. Cleary’s entrepreneurial spirit has served him well. He’s used the hush money from Cornelia to buy an automobile that he’s leasing to Barrow as an ambulance. Add to this, he’s lining his pockets running side business training and betting on amateur boxers.

While we are on the subject of boxing, Dr. Edwards’s penchant for rumbling with prizefighters as a form of self-flagellation has resulted in a detached retina for which is there is no treatment. (As with Thack, it’s starting to become apparent that Edwards’s own his inner demons pose a significant threat to his career.) He’s cautioned that any more injury to the eye will most likely blind him. But damage has been done. During a fairly routine procedure in the operating theater, Edwards turns the reigns over to a slightly surprised Bertie Chickering because he is unable to see into the dark cavity in the patient’s abdomen.

Failing vision or not, Edwards remains resolute in his goal to earn the respect of the hospital board and to receive what he feels (probably rightly) is his due. At a board meeting, where he’s done the dishonor of being asked to wait outside, he announces his wish to be named chief surgeon. It should come as no surprise that the overseers of The Knick would prefer a more “suitable” candidate (their word not mine). Naturally it’s not necessary to spell out what this means, although they do gild the lily by proposing a search that will take them up to Dartmouth, which is possibly the whitest place in New England.

However, Henry Robertson, who has taken his sister Cornelia’s place on the board and as Edwards’s champion, has Algie’s back. He acknowledges that the board is not comprised of the “sort of men who want to make history” but promises that he will bring them along, even pulling a fast one by sneaking Dr. Edwards into the ceremonial photograph commemorating the groundbreaking on the new hospital building.

One person Henry will never “bring along” is the aggressively intolerant Dr. Gallinger. Gallinger’s blatant racism makes him an impossible character to pity, despite the tragedy of his daughter’s death and his wife’s madness. The look of impatient revulsion he gives his wife as she’s sorting through an enamel bowl of teeth (ick) to fix her destroyed mouth pretty much sums up Gallinger—his compassion even for his loved ones has limits. (The teeth come from the morgue in case you’re wondering. And the tooth merchant promises a new supply in a few days.)

Yet it’s Gallinger who, despite impure intentions, is the hero of this episode. Unable to stomach being subordinate to Edwards, he pays a visit to Thack up at the sanitarium in the hope that he’s ready to resume his post as chief of surgery. But Thack has gone full Trainspotting, scratching, jonsing, and accusing the staff of messing with the clock to delay his next fix.

In a strange but inspired move, Gallinger kidnaps Dr. Thackery and ties him up in the hold of his sailboat, which is a nice visual reprieve from the dark confines of The Knickerbocker Hospital. He keeps Thack bound by the wrists until he kicks dope (which is really no way to treat your boss, but Thack will probably forgive him). After the physical symptoms of withdrawal pass, Gallinger charges Dr. Thackery with learning how to tie ten natural knots—only then will he be convinced the doc’s mind and hands are restored.

Thack masters the knots with the peculiar zeal his brings to most things he is invested in—drugs, blood type analysis, performing successful placenta praevia surgery. And as the episode ends, it appears he’s ready to return to The Knick, where they’re going to need him. An outbreak of bubonic plague has come into the city through Ellis Island, and Ping Yu, who’s now running Collier’s book, has cut a deal with Barrow (who’s in his debt) to treat his stable of prostitutes at the hospital. It seems that Nurse Elkins is going to get her wish—her days are not going to remain mundane for long.

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